Behavioral Health Clinical Administrative Coordinator

About the position At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable, and equitable. Ready to make a difference? Join us to start Caring. Connecting. Growing together. The Clinical Administrative Assistant validates eligibility for authorization requests and prepares Behavioral Health and Substance Use Disorder authorizations across various lines of business. They collaborate with leadership, refer members for aftercare planning, and notify providers of authorization determinations. They offer peer-to-peer consultations for cases not meeting criteria, drafts denial letters, and assists callers promptly. They handle incomplete requests, take meeting notes, maintain confidentiality, and manage escalated calls. Additionally, they apply clinical knowledge to guidelines, monitor the fax queue, verify documentation, and maintain job aids. Responsibilities • Verifies eligibility of providers and members for all authorization requests • Inputs and prepares all Behavioral Health and Substance Use Disorder authorizations submitted by providers for all lines of business • Refers members to the RMHP Care Coordination Department when completing discharge documentation • Notifies providers and requestors of all authorization determinations when appropriate • Corresponds with the requesting provider to offer a peer-to-peer consultation when a case does not meet criteria • Drafts denial letters informing members and providers of decisions and offers alternative treatment options • Provides assistance to callers routed to the BH UM department • Completes required trainings by assigned due dates to comply with auditing entities • Attempts to obtain missing information from requestors for incomplete authorization requests • Takes detailed notes of meetings attended and shares with attendees • Provides consultation to providers and/or consumers on various issues • Respects confidentiality and maintains confidences as described in the UHG Employee Handbook • Establishes and maintains professional working relations with referral sources and care providers • Handles escalated calls and resolves complex issues • Sends correspondence to practitioners, providers, and members regarding authorization status • Verifies and uploads valid Release of Information documentations to electronic health records • Organizes and manages authorization requests • Ensures the Utilization Management Team references the most updated member handbooks • Creates bookmarks in authorizations pulled for audits • Corrects errors identified in various reports • Enters Single Case Agreements into the electronic health record • Maintains and updates job aids for team functions as needed • Completes all duties in accordance with company safety policies and practices Requirements • High School Diploma/GED (or higher) • 2+ years of experience analyzing and solving customer problems • 2+ years of experience working in the healthcare industry • 2+ years of experience working with medical or behavioral health terminology • Intermediate level of computer/typing proficiency • Ability to work Mountain Time Zone schedule • Access to a designated quiet workspace in your home • Reside in the United States • Reside in a location that can receive a UnitedHealth Group approved high-speed internet connection Nice-to-haves • Previous experience working in the Colorado healthcare industry • 6+ months of experience with EMR (electronic medical records) systems • Previous data entry experience • Previous experience working remotely Benefits • Paid Time Off which you start to accrue with your first pay period plus 8 Paid Holidays • Medical Plan options along with participation in a Health Spending Account or a Health Saving account • Dental, Vision, Life & AD&D Insurance along with Short-term disability and Long-Term Disability coverage • 401(k) Savings Plan, Employee Stock Purchase Plan • Education Reimbursement • Employee Discounts • Employee Assistance Program • Employee Referral Bonus Program • Voluntary Benefits (pet insurance, legal insurance, LTC Insurance, etc.) Apply tot his job